Neurosurgery is characterized by complex anatomy and highly precise surgical procedures, which needs spatial cognition, clinical thinking, as well as practical skills for medical students. Traditional neurosurgical internship education mainly relies on didactic teaching, imaging materials, and surgical observation, which might not fully meet the requirements of modern medical education. Along with the rapid development of medical image processing, computer graphics and human–computer interaction technologies, virtual simulation technology has been increasingly applied in neurosurgical education in recent years. Through virtual reality, augmented reality, or mixed reality technologies, virtual simulation could convert two-dimensional medical information into visualized and interactive three-dimensional models, providing students with a more intuitive learning experience which closely resembles real clinical scenarios. This review summarizes the current applications of virtual simulation technology in neurosurgical internship education, discusses existing challenges, and provides perspectives on future developments.